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Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature

We reviewed the literature on cerebrospinal fluid (CSF) studies in patients who had a seizure in the setting of COVID-19 infection to evaluate for evidence of viral neuroinvasion. We performed a systematic review of Medline and Embase to identify publications that reported one or more patients with...

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Autores principales: Carroll, Elizabeth, Melmed, Kara R., Frontera, Jennifer, Placantonakis, Dimitris G., Galetta, Steven, Balcer, Laura, Lewis, Ariane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Epilepsy Association. Published by Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8127527/
https://www.ncbi.nlm.nih.gov/pubmed/34044299
http://dx.doi.org/10.1016/j.seizure.2021.05.003
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author Carroll, Elizabeth
Melmed, Kara R.
Frontera, Jennifer
Placantonakis, Dimitris G.
Galetta, Steven
Balcer, Laura
Lewis, Ariane
author_facet Carroll, Elizabeth
Melmed, Kara R.
Frontera, Jennifer
Placantonakis, Dimitris G.
Galetta, Steven
Balcer, Laura
Lewis, Ariane
author_sort Carroll, Elizabeth
collection PubMed
description We reviewed the literature on cerebrospinal fluid (CSF) studies in patients who had a seizure in the setting of COVID-19 infection to evaluate for evidence of viral neuroinvasion. We performed a systematic review of Medline and Embase to identify publications that reported one or more patients with COVID-19 who had a seizure and had CSF testing preformed. The search ranged from December 1st 2019 to November 18th 2020. We identified 56 publications which described 69 unique patients who met our inclusion criteria. Of the 54 patients whose past medical history was provided, 2 (4%) had epilepsy and 1 (2%) had a prior seizure in the setting of hyperglycemia, but the remaining 51 (94%) had no history of seizures. Seizure was the initial symptom of COVID-19 for 15 (22%) patients. There were 26 (40%) patients who developed status epilepticus. SARS-CoV-2 PCR testing was performed in the CSF for 45 patients; 6 (13%) had a positive CSF SARS-CoV-2 PCR, only 1 (17%) of whom had status epilepticus. The cycle thresholds were not reported. Evaluation for CSF SARS-CoV-2 antibodies (directly or indirectly, via testing for CSF oligoclonal bands or immunoglobulins) was performed in 26 patients, only 2 (8%) of whom had evidence of intrathecal antibody synthesis. Of the 11 patients who had CSF autoimmune antibody panels tested, 1 had NMDA antibodies and 1 had Caspr-2 antibodies. Detection of SARS-CoV-2 in the CSF of patients with seizures who have COVID-19 is uncommon. Our review suggests that seizures in this patient population are not likely due to direct viral invasion of the brain.
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spelling pubmed-81275272021-05-18 Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature Carroll, Elizabeth Melmed, Kara R. Frontera, Jennifer Placantonakis, Dimitris G. Galetta, Steven Balcer, Laura Lewis, Ariane Seizure Review We reviewed the literature on cerebrospinal fluid (CSF) studies in patients who had a seizure in the setting of COVID-19 infection to evaluate for evidence of viral neuroinvasion. We performed a systematic review of Medline and Embase to identify publications that reported one or more patients with COVID-19 who had a seizure and had CSF testing preformed. The search ranged from December 1st 2019 to November 18th 2020. We identified 56 publications which described 69 unique patients who met our inclusion criteria. Of the 54 patients whose past medical history was provided, 2 (4%) had epilepsy and 1 (2%) had a prior seizure in the setting of hyperglycemia, but the remaining 51 (94%) had no history of seizures. Seizure was the initial symptom of COVID-19 for 15 (22%) patients. There were 26 (40%) patients who developed status epilepticus. SARS-CoV-2 PCR testing was performed in the CSF for 45 patients; 6 (13%) had a positive CSF SARS-CoV-2 PCR, only 1 (17%) of whom had status epilepticus. The cycle thresholds were not reported. Evaluation for CSF SARS-CoV-2 antibodies (directly or indirectly, via testing for CSF oligoclonal bands or immunoglobulins) was performed in 26 patients, only 2 (8%) of whom had evidence of intrathecal antibody synthesis. Of the 11 patients who had CSF autoimmune antibody panels tested, 1 had NMDA antibodies and 1 had Caspr-2 antibodies. Detection of SARS-CoV-2 in the CSF of patients with seizures who have COVID-19 is uncommon. Our review suggests that seizures in this patient population are not likely due to direct viral invasion of the brain. British Epilepsy Association. Published by Elsevier Ltd. 2021-07 2021-05-17 /pmc/articles/PMC8127527/ /pubmed/34044299 http://dx.doi.org/10.1016/j.seizure.2021.05.003 Text en © 2021 British Epilepsy Association. Published by Elsevier Ltd. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Review
Carroll, Elizabeth
Melmed, Kara R.
Frontera, Jennifer
Placantonakis, Dimitris G.
Galetta, Steven
Balcer, Laura
Lewis, Ariane
Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature
title Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature
title_full Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature
title_fullStr Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature
title_full_unstemmed Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature
title_short Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature
title_sort cerebrospinal fluid findings in patients with seizure in the setting of covid-19: a review of the literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8127527/
https://www.ncbi.nlm.nih.gov/pubmed/34044299
http://dx.doi.org/10.1016/j.seizure.2021.05.003
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